NPIMap

Organization Active NPI

Geneva Family Dentistry, LLC

  • Dentist
  • Geneva, AL
National Provider Identifier
1972863348
Registry record updated May 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5826 Issued in AL
Legal business name
GENEVA FAMILY DENTISTRY, LLC
Practice address
100 W Lake Professional Park
Suite 5
Geneva, AL 36340-1203
Phone
(334) 805-3975
NPI assigned
May 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jonathan David Markham, DMDNPI 1891088548
Title
Sole Member-Owner
Phone
(334) 805-3975

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5826 AL Primary

Addresses

Primary practice location

100 W Lake Professional Park
Suite 5
Geneva, AL 36340-1203

Mailing address

100 W Lake Professional Park
Suite 5
Geneva, AL 36340-1203
Phone (334) 805-3975

National Provider Directory

National Provider Directory

Locations

100 W Lake Professional Park
Ste 5
Geneva, AL 36340
Phone (334) 684-3919

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337472000000",
    "number": "1972863348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W LAKE PROFESSIONAL PARK",
            "address_2": "SUITE 5",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363401203",
            "telephone_number": "334-805-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W LAKE PROFESSIONAL PARK",
            "address_2": "SUITE 5",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363401203",
            "telephone_number": "334-805-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVA FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-20",
        "last_updated": "2012-05-20",
        "status": "A",
        "authorized_official_last_name": "MARKHAM",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE MEMBER-OWNER",
        "authorized_official_telephone_number": "334-805-3975",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "5826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.